Development of an Applied Framework for Understanding Health Information Technology in Nursing Homes.

There is growing evidence that Health Information Technology (HIT) can play a role in improving quality of care and increasing efficiency in the nursing home setting. Most research in this area, however, has examined whether nursing homes have or use any of a list of available technologies. We sought to develop an empirical framework for understanding the intersection between specific uses of HIT and clinical care processes. Using the nominal group technique, we conducted a series of focus groups with different types of personnel who work in nursing homes (administrators, directors of nursing, physicians, mid-level practitioners, consultant pharmacists, and aides). The resulting framework identified key domain areas that can benefit from HIT: transfer of data, regulatory compliance, quality improvement, structured clinical documentation, medication use process, and communication. The framework can be used to guide both descriptive and normative research.

[1]  Rainu Kaushal,et al.  Bmc Medical Informatics and Decision Making Assessing the Level of Healthcare Information Technology Adoption in the United States: a Snapshot , 2005 .

[2]  Gregory L. Alexander,et al.  Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly , 2011, Int. J. Medical Informatics.

[3]  J. Hanlon,et al.  Utility of an adverse drug event trigger tool in Veterans Affairs nursing facilities. , 2013, The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists.

[4]  Gregory L Alexander,et al.  Information technology sophistication in nursing homes. , 2009, Journal of the American Medical Directors Association.

[5]  Jullet A. Davis,et al.  Organizational factors associated with the use of information systems in nursing homes , 2009, Health Care Management Review.

[6]  P. Aspden,et al.  Preventing Medication Errors , 2007 .

[7]  Sujha Subramanian,et al.  Computerized Physician Order Entry with Clinical Decision Support in Long‐Term Care Facilities: Costs and Benefits to Stakeholders , 2007, Journal of the American Geriatrics Society.

[8]  Janet M. Corrigan,et al.  Key Capabilities of an Electronic Health Record System: Letter Report , 2004 .

[9]  Susan D Horn,et al.  Exploratory Study of Nursing Home Factors Associated with Successful Implementation of Clinical Decision Support Tools for Pressure Ulcer Prevention , 2013, Advances in skin & wound care.

[10]  Greg Alexander,et al.  Cost, staffing and quality impact of bedside electronic medical record (EMR) in nursing homes. , 2010, Journal of the American Medical Directors Association.

[11]  Subashan Perera,et al.  Identifying modifiable barriers to medication error reporting in the nursing home setting. , 2007, Journal of the American Medical Directors Association.

[12]  David H. Gustafson,et al.  Group Techniques for Program Planning: A Guide to Nominal Group and Delphi Processes , 1976 .

[13]  Karabi C. Bezboruah,et al.  Utilization of Technology by Long-Term Care Providers , 2013, Journal of aging and health.

[14]  S. Handler,et al.  Use of HIT for adverse event reporting in nursing homes: barriers and facilitators. , 2013, Geriatric nursing.

[15]  Terry S. Field,et al.  Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study , 2012, J. Am. Medical Informatics Assoc..

[16]  Sophia Chan,et al.  Factors associated with the use of electronic information systems for drug dispensing and medication administration records in nursing homes. , 2008, Journal of the American Medical Directors Association.

[17]  M. Gallagher,et al.  The nominal group technique: a research tool for general practice? , 1993, Family practice.

[18]  A. Delbecq,et al.  The nominal group as a research instrument for exploratory health studies. , 1972, American journal of public health.

[19]  Helaine E. Resnick,et al.  Use of electronic information systems in nursing homes: United States, 2004. , 2009, Journal of the American Medical Informatics Association : JAMIA.

[20]  Barbara Cherry,et al.  Assessing organizational readiness for electronic health record adoption in long-term care facilities. , 2011, Journal of gerontological nursing.